Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 003575 | NY |
NPI | 1134264526 |
---|---|
Provider Name | Joe Frandina |
First Address | Buffalo, NY 14216-2838 |
Second Address | Buffalo, NY 14216-2838 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00027234901 | UNIVERA (01) | NY |
118627 | EYEMED (01) | NY |